Alcohol Intake Assessment

  • Please complete this form to help your nurse to assist you in reviewing your alcohol intake. It is important that you give accurate scores, as the scores provided will be used to help your nurse to provide you with the best advice and support to help you with reducing your alcohol intake.
  • Date Format: MM slash DD slash YYYY
  • This is one unit of alcohol:
  • And each one of these is more than one unit:
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SURGERY HOURS

Monday – Friday* 08:00 – 20:00
 Saturday** 09:00 – 17:00

*Surgery reception closed between 1pm-2pm every Weds for training

**North Croydon GP Enhanced Access & Reception Service only

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USEFUL CONTACTS

General enquires & appointments (from 8.30am):
020 8689 7800
Brigstock Skin and Laser Centre
0330 555 6060
NHS Croydon:
020 8274 6000
Patient advice and liaison service (PALS):
020 8274 6333
Public Health Department:
020 8274 6239
 Croydon Intermediate Ear Nose and Throat service
020 8683 6734
 NHS Out of hours service
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Data Protection Officer 
Umar Sabat | Email: dpo.swl@nhs.net